title: Primary multiple cerebral hydatid disease: still symptomatic despite pathologically confirmed death of the cyst.
abstract: Hydatid disease is a life-threatening parasitic infestation caused by Echinococcus granulosus. Infection with E. granulosus typically results in the formation of hydatid cysts in liver, lungs, kidney and spleen. Majority of the intracranial cysts are secondary and solitary. Multiple primary cerebral cysts are uncommon. Surgical and medical management of a 14-year-old boy with multiple primary hydatid cysts are presented. 14 cysts, which were symptomatic due to their mass effect, were surgically removed, whereas a deep-seated asymptomatic cyst was followed-up with medical treatment. Despite proper antibiotic regimen the patient was admitted with epileptic seizures six months later. The deep-seated lesion was also surgically removed. Intraoperative observations and pathological examination demonstrated different characteristics, with pericystic gliosis, gel-like cyst content and death scolices within the cavity. In addition to the fact, that the presented case is an additional example for the rare primary multiple cerebral hydatid cysts, to our knowledge it is the first case of a dead cerebral hydatid cyst, causing symptoms despite effective medical treatment.
authors.affiliation: Istanbul University, Istanbul Faculty of Medicine, Department of Neurosurgery, Istanbul, Turkey.
authors.forename: Umut
authors.initials: U
authors.lastname: Yaka
authors.forename: Yavuz
authors.initials: Y
authors.lastname: Aras
authors.forename: Aydın
authors.initials: A
authors.lastname: Aydoseli
authors.forename: Mehmet Osman
authors.initials: MO
authors.lastname: Akcakaya
authors.forename: Altay
authors.initials: A
authors.lastname: Sencer
authors.forename: Murat
authors.initials: M
authors.lastname: Imer
authors.forename: Kemal
authors.initials: K
authors.lastname: Hepgul
mesh_terms: D000293:Adolescent; D015766:Albendazole / Q000627:therapeutic use; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use; D004172:Diplopia / Q000209:etiology; D004443:Echinococcosis / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery*; D048209:Echinococcus granulosus; D006261:Headache / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009325:Nausea / Q000209:etiology; D019635:Neurosurgical Procedures / Q000379:methods*; D009778:Occipital Lobe / Q000601:surgery; D012640:Seizures / Q000209:etiology; D016896:Treatment Outcome
chemical_list: D000871:Anthelmintics; D015766:Albendazole